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Tuesday, December 20, 2011

Tuesday's Science News

There is an interview with an internist from Nova Scotia in The New Old Age postings column in today's NY Times Science section. He speaks of the language we use to speak of end of life, but what struck me most was the use of language that suggests the patient is to blame. For example, "Your mother failed to respond to treatment." He suggests instead, "Our treatment is not working." 
I am so tired of people who blame the child or the demented person when an accident happens or a planned event is spoiled. Hooray for Dr. Stephen Workman who shows us how important it is to speak clearly, honestly and without blame. Dr. Workman also does not like the phrase "We're switching to comfort care." What kind of care was the person receiving before? Hurtful care?
I learned yesterday the language for the levels of care in a residential facility for the infirm--supervisory care, personal care and direct care.In the first level of care, the person is independent; able to attend to his/her own needs for dressing, toileting, feeding and ambulation. In the second level, the person needs some direction or assistance with these skills of  daily living. In the third level, the person needs direct care in these areas. No longer will a staff member tell me "Bob is putting on soiled clothing" or "Bob is getting up from the table during his meals." Only the clothing he is wearing will be available to him and he will be spoken to, and asked what the matter is, that he had to leave the table.
In my years of helping parents develop the skills to raise their children successfully, it was always important, too, to help the parent use language to see the child as wanting to cooperate and to look for the reason Johnny was "always into everything" or "always misbehaving." Some parents believe their two year-old child "has the devil in him" or is purposely misbehaving to annoy the parents.Quite often these parents were very uncomfortable when Johnny interacted quietly and in a goal-directed manner in my office.

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